Rucabarib: A new lease of life for ovarian cancer patients.

BACKGROUND: Rucaparib is a drug with potential as maintenence monotherapy in ovarian cancers irrespective of genetic mutation. METHODS: The results of the ARIEL 3 trial were analysed for the drug's prospects towards cure in ovarian and other pelvic malignancies. RESULTS: Ovarian cancer patients with highly malignant tumors and relapses on platinum based chemotherapy exhibited statistically significant reductions in tumor size with maintenance Rucaparib therapy vis a vis placebo. CONCLUSION: Genetic heterogeneity of the tumor did not have an impact upon Rucaparib efficacy in ovarian carcinoma. More malignant and relapsed variants can effectively be treated with Rucaparib, thereby improving survival rates and quality of life.

Comparison of four diagnostic techniques for detection of Trichomonas vaginalis infection in females attending tertiary care hospital of North India.

BACKGROUND: Trichomonas vaginalis causes a common sexually transmitted disease trichomoniasis, which may lead to increased risk of transmission of human immunodeficiency virus infection and other pelvic inflammatory diseases. Wet mount examination is the most common test for diagnosis, but it has low sensitivity. Acridine orange staining can be used for diagnosis, but it requires special microscopic facility. Culture is considered as the gold standard, but it takes a long time for diagnosis. OSOM Trichomonas Rapid Test is a recently introduced rapid method based on immunochromatographic assay of trichomonal protein antigens. Hence, the present study was done to compare these four diagnostic techniques for detection of trichomoniasis in females with vaginal discharge. MATERIALS AND METHODS: Vaginal swabs were taken from 835 female patients and wet mount examination, acridine orange staining, culture in Kupferberg medium, and OSOM Trichomonas Rapid Test, were performed. RESULTS: Out of 835 patients included in our study, 68 (8.1%) positive cases of trichomoniasis were detected by culture. OSOM Trichomonas Rapid Test detected 63 (7.5%) cases, acridine orange staining detected 53 (6.3%) cases, whereas, wet mount examination detected only 45 (5.4%) positive cases. OSOM Trichomonas Rapid Test performed well and showed high sensitivity and specificity of 88.2% and 99.6%, respectively. CONCLUSION: As OSOM Trichomonas Rapid Test is a point of care test and gave better results than both wet mount examination and acridine orange staining; it can be used as a routine test in peripheral areas lacking laboratory facilities.

IgG avidity antibodies against Toxoplasma gondii in high risk females of reproductive age group in India.

Toxoplasma gondii is an obligate intracellular protozoan that is distributed worldwide. Recently, several tests for avidity of Toxoplasma IgG antibodies have been introduced to help discriminate between recently acquired and distant infections. The study was conducted in Jawaharlal Nehru Medical College and Hospital, India from February 2011 to September 2012. Serum specimens were subjected to Toxoplasma IgM ELISA and IgG avidity ELISA test. Out of 48 patients with abortions, 17 (35.4%) were positive for IgM ELISA, and 8 (16.6%) had low IgG avidity antibodies. Out of 48 patients with other obstetric problems, 23 (47.9%) were positive for IgM ELISA, and 17 (35.4%) had low IgG avidity antibodies. Combining both groups on avidity test, only 25 of 40 (62.5%) IgM-positive women had low-avidity IgG antibodies suggesting a recent T. gondii infection in these women. More importantly, 15 (37.5%) of the IgM-positive women had high-avidity antibodies suggesting that the infection was acquired before gestation The relation of IgM seropositivity with the following risk factors was not found to be statistically significant; contact with cats (0.13), non-vegetarian food habits (0.05), and low socio-economic status (0.49). While, for IgG avidity ELISA, only contact with cats (0.01) was significantly associated with seropositivity. All other risk factors have P-values of >0.05 (not significant). IgG avidity test when used in combination with IgM test was a valuable assay for diagnosis of ongoing or recently acquired T. gondii infection in India.

Evaluation of Different Staining Techniques in the Diagnosis of Trichomonas vaginalis Infection in Females of Reproductive Age Group.

BACKGROUND: Trichomonas vaginalis is a parasitic protozoan which causes most common non viral sexually transmitted disease trichomoniasis. Direct microscopic examination of vaginal fluid remains the most widely used diagnostic test. Although, wet mount examination is the most cost-effective diagnostic test, but it has low sensitivity resulting in under diagnosis of the disease. Therefore, to overcome this problem, various staining techniques like giemsa and acridine orange can be used along with wet mount examination for diagnosis of T. vaginalis infection. OBJECTIVE: The present study was done to evaluate the efficacy of Giemsa and Acridine Orange staining in comparison with wet mount examination for the diagnosis of vaginal trichomoniasis. MATERIALS AND METHODS: A total of 615 female patients of reproductive age group having vaginal discharge were included in the study and swabs containing vaginal fluids were taken to perform wet mount examination, giemsa staining and acridine orange staining. RESULT: Trichomonas vaginalis infection was detected in 37 patients with maximum cases (6.0%) detected by acridine orange staining, followed by giemsa staining (4.9%), whereas, wet mount examination was able to detect only 4.1% cases. Wet mount examination gave a sensitivity of 67.6%, whereas, the sensitivity of giemsa staining and acridine orange staining was found to be 80% and 100% respectively. CONCLUSION: Since the performance of both the staining techniques was found to be much better in comparison to wet mount examination, and they also detected several wet mount negative cases, they should be used as an adjunct to wet mount examination. This will also be beneficial to the overall health of the patient by early diagnosis and treatment of cases, thereby, reducing the development of associated morbidity.

Autosomal recessive polycystic kidney disease: the importance of autopsy of suspected cases and genetic counselling.

Autosomal recessive polycystic kidney disease (ARPKD) is a common inheritable cystic renal disease that has a profound effect on the growing fetus and on subsequent pregnancies, being fatal in 30% to 50% cases in the neonatal period. Prenatal imaging studies are only suggestive of the disorder and it is evident only from the second trimester onwards. Prenatal molecular linkage analysis can identify the disorder, but have a prerequisite of previous DNA analysis of parents and one sibling. ARPKD can be accurately diagnosed on characteristic histopathological features if an autopsy is performed in cases of infant death where the prenatal imaging studies and clinical findings are suggestive of the disease. A case of the characteristic histopathological findings of ARPKD on autopsy of a live-born neonate who died shortly after birth, with prenatal ultrasonographic findings suggestive of renal cystic disease, is presented.